GLOBAL LEADERS: A Clinical Study Comparing Two Forms of Anti-platelet Therapy After Stent Implantation
Coronary Artery Disease (CAD)

About this trial
This is an interventional treatment trial for Coronary Artery Disease (CAD) focused on measuring CAD, ACS, All comers, DAPT, PCI
Eligibility Criteria
Inclusion Criteria:
-"All comer" patients
- Age ≥18 years;
- Presence of one or more coronary artery stenoses of 50% or more in a native coronary artery or in a saphenous venous or arterial bypass conduit suitable for coronary stent implantation. The vessel should have a reference vessel diameter of at least 2.25 mm (no limitation on the number of treated lesions, vessels, or lesion length);
- Able to provide informed consent and willing to participate in 2 year follow- up period.
Exclusion Criteria:
- Known intolerance to aspirin, P2Y12 inhibitors, bivalirudin, stainless steel or biolimus;
- Known intake of a strong CYP3A4 inhibitor (e.g., ketoconazole, clarithromycin, nefazodone, ritonavir, and atazanavir), as co-administration may lead to a substantial increase in exposure to ticagrelor;
- Known moderate to severe hepatic impairment (alanine-aminotransferase ≥ 3 x ULN);
- Planned surgery, including coronary artery bypass graft (CABG) as a staged procedure (hybrid) within 12 months of the index procedure, unless dual antiplatelet therapy is maintained throughout the peri-surgical period;
- Need for chronic oral anti-coagulation therapy;
- Active major bleeding or major surgery within the last 30 days;
- Known history of intracranial haemorrhagic stroke or intra-cranial aneurysm;
- Known stroke (any type) within the last 30 days;
- Known pregnancy at time of randomisation;
- Female who is breastfeeding at time of randomisation;
- Currently participating in another trial and not yet at its primary endpoint.
Sites / Locations
- Research centre Brisbane, 6101
- Research centre Melbourne, 6104
- Research centre Melbourne, 6105
- Research centre Graz, 4305
- Rsearch centre Innsbruck, 4303
- Research centre Linz, 4304
- Research centre Vienna, 4301
- Research centre Vienna, 4302
- Research centre Aalst, 3201
- Research centre Aalst, 3206
- Research centre Bonheiden, 3204
- Research centre Charleroi, 3202
- Research centre Genk, 3205
- Research centre Hasselt, 3203
- Research centre Rio de Janeiro, 5503
- Research centre Rio de Janeiro, 5504
- Research centre Sao Paulo, 5501
- Research centre Sao Paulo, 5502
- Research centre Uberlândia, 5505
- Research centre Burgas, 9902
- Research centre Plovdiv, 9905
- Research centre Sofia, 9901
- Research centre Sofia, 9903
- Research centre Sofia, 9904
- Research centre Sofia, 9907
- Research centre Sofia, 9908
- Research centre Varna, 9906
- Research centre Newmarket, 1003
- Research centre Quebec, 1001
- Research centre Copenhagen, 4501
- Research centre Roskilde, 4503
- Research centre Aix en Provence, 3311
- Research centre Caen, 3308
- Research centre Caen, 3309
- Research centre Clermont-Ferrand, 3303
- Research centre Dijon, 3313
- Research centre Grenoble, 3312
- Research centre Lyon, 3316
- Research centre Nancy, 3314
- Research centre Paris, 3301
- Research centre Paris, 3305
- Research centre Rouen, 3307
- Research centre Saint Etienne, 3310
- Research centre Toulouse, 3302
- Research centre Bad Krozingen, 4904
- Research centre Bad Nauheim, 4902
- Research centre Berlin, 4918
- Research centre Bonn, 4911
- Research centre Dresden, 4908
- Research centre Essen, 4903
- Research centre Fulda, 4905
- Research centre Giessen 4901
- Research centre Göttingen, 4907
- Research centre Landshut, 4909
- Research centre Lubeck, 4917
- Research centre Mainz, 4910
- Research centre Mannheim, 4912
- Research centre Mönchengladbach, 4915
- Research centre Neuss, 4916
- Research centre Tubingen, 4914
- Research centre Villingen - Schwenningen, 4919
- Research centre Balatonfüred, 3608
- Research centre Budapest, 3602
- Research centre Budapest, 3603
- Research centre Debrecen, 3607
- Research centre Gyula, 3606
- Research centre Nyíregyháza, 3605
- Research centre Pécs, 3604
- Research centre szeged, 3601
- Research centre Arezzo, 3902
- Research centre Brescia, 3912
- Research centre Ferrara, 3905
- Research centre Milano, 3901
- Research centre Pavia, 3903
- Research centre Terni, 3909
- Research centre Alkmaar, 3106
- OLVG Research centre Amsterdam, 3104
- UMCG Groningen, 3108
- Research centre Leeuwarden, 3102
- Research centre Nieuwegein, 3107
- Research centre Nijmegen, 3105
- EMC Rotterdam, 3101
- Maasstad Rotterdam, 3103
- Research centre Tilburg, 3109
- Research centre Chrzanow, 4802
- Research centre Dabrowa Gornicza, 4801
- Research centre Kedzierzyn-Kozle, 4805
- Research centre Krakov, 4807
- Research centre Mielec, 4809
- Research centre Nysa, 4808
- Research centre Ustroń, 4803
- Research centre Gaia, 3501
- Research centre Lisbon, 3503
- Research centre Lisbon, 3504
- Research centre Lisbon, 3505
- Research centre Singapore, 6501
- Research centre Singapore, 6502
- Research centre Barcelona, 3401
- Research centre Barcelona, 3403
- Research centre Barcelona, 3405
- Research centre Huelva, 3408
- Research centre Madrid 3410
- Research centre Madrid, 3402
- Research centre Madrid, 3407
- Research centre Madrid, 3409
- Research centre Vigo, 3404
- Research centre Bern, 4106
- Research centre Bern, 4107
- Research centre Geneva, 4101
- Research centre Lausanne, 4104
- Research centre Liestal, 4108
- Research centre Lugano, 4105
- Research centre Belfast, 4420
- Research Centre Belfast, 4423
- Research centre Blackburn, 4404
- Research centre Blackpool, 4408
- Research centre Bournemouth, 4418
- Research centre Brighton, 4405
- Research centre Cambridge, 4417
- Research centre Cardiff, 4402
- Research centre Glasgow, 4407
- Research centre Leicester, 4421
- Research centre Liverpool, 4001
- Research centre Manchester, 4403
- Research centre Manchester, 4406
- Research centre Newcastle, 4413
- Research centre Rhyl, 4414
- Research centre Southampton, 4415
- Research centre Stevenage, 4412
- Research centre Wolverhampton, 4422
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Experimental treatment strategy
Reference treatment strategy
All patients in the treatment group will receive acetylsalicylic acid (ASA) and ticagrelor for 1 month followed by 23 months of ticagrelor monotherapy. Dosage and frequency: Ticagrelor: 90 mg b.i.d. ASA: of 75mg qd (- ≤ 100 mg qd)
Acute Coronary Syndrome (ACS) patients incl. unstable angina (UA) patients: ASA and Brilique(ticagrelor) for 12 months followed by 12 months of ASA monotherapy. Stable Coronary Artery Disease (CAD) patients: ASA and clopidogrel for 12 months followed by 12 months of ASA monotherapy. Dosage and frequency: Brilique(Ticagrelor): 90 mg b.i.d. ASA: of 75mg qd (- ≤ 100 mg qd) Clopidogrel: 75 mg qd